阻塞性睡眠呼吸暂停（OSA）和胆固醇
可以睡眠影响胆固醇？
阻塞性睡眠呼吸暂停（OSA）是在睡眠期间在正常呼吸模式中产生不同程度的重复上气道阻塞的条件。随着该区域的肌肉在睡眠期间完全放松，上气道的软组织可以崩溃。然后可以发生完整或部分障碍物。这触发了对闭合空气道的增加的呼吸努力，从睡眠中导致多次觉醒。结果，OSA的一些常见症状包括白天疲劳和嗜睡。其他症状包括沮丧的情绪，早晨头痛，晚上增加排尿，有时是失眠本身。OSA是几年被认可的常见条件。据估计，美国约有25％的成年人面临这种情况的风险。一些风险因素包括肥胖，上部气道等异常，如大扁桃体，吸烟和diabetes。OSA can be readily diagnosed by an overnight sleep study (polysomnography) during which time the pulse rate and oxygen levels are recorded during sleep. A severity index can then be generated by counting the number of episodes of disturbed breathing that occurs during a period of sleep. The mainstay treatment for significant OSA is continuous positive airway pressure (CPAP). This therapy is delivered through a nasal or face mask through which continuous air pressure is delivered in order to keep the upper airway open. OSA has become increasingly important in that it has been linked to and may contribute to the development of other serious medical conditions such as hypertension, abnormal heart rhythms, and congestive heart failure. OSA may also increase the risk ofheart disease这是一个可能的原因是它的不利影响胆固醇。
2006年,一对文章出现在书中l literature looking specifically at the relationship between OSA and cholesterol. The US study was a relatively small one that essentially did not demonstrate any significant relationship between cholesterol and OSA in 62 male patients. However, a much larger German study looked at over 400 patients with varying degrees of OSA and concluded that the more severe the OSA, the lower the HDL and higher the triglyceride levels. There was no significant relationship between OSA and total or LDL cholesterol levels. A second part of this German study evaluated the effects of positive airway pressure on lipid levels. In these 86 patients in whom they followed while receiving OSA treatment, the authors observed that as OSA improved, HDL levels rose ~6%. This is not a huge difference but was still significant nonetheless. In the following year, a Greek study also examined the effects of CPAP on cholesterol in patients with OSA. They concluded that CPAP over a 6 month period did lower overall cholesterol and increased HDL levels.
不清楚OSA和胆固醇之间的机械联系。其中一个人认为，在呼吸阻塞时期，肾上腺素水平显着和长期增加。高肾上腺素水平与较低的HDL水平和较高的甘油三酯水平有关。另一种思想涉及OSA对饮食习惯的影响。今年发表的一项研究表明，OSA促进了饮食习惯差，有助于体重增加和肥胖。这导致胆固醇较差的水平。已知疲劳是常见的营养习惯和OSA患者常常在白天疲劳。从某种意义上说，OSA可以成为肥胖人民的恶性循环，因为肥胖的人促进了OSA，而且OSA可以促进肥胖。CPAP对改善HDL和甘油三酯的影响也可能本质上是膳食的，因为疲劳减少，更好的饮食选择。此外，少日间疲劳会导致更多的身体活动和运动。 The effects of exercise on cholesterol include lowering triglycerides and increasing HDL.
总之，OSA是一种常见的疾病，不仅可以与重大症状有关，而且还可以促进对不利影响心脏健康的其他显着疾病的发展。胆固醇似乎受到OSA和CPAP治疗对OSA的不利影响，可以衰减这些效果。此外，OSA的治疗可以促进更好的饮食习惯和更多的身体活动，这是保持良好胆固醇水平的关键组分。
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